Placenta Previa: Questions To Ask?

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So I prepared a list of questions to ask my OB on tomorrow at my appointment. I compiled them from Q&A's I found on other blogs and added questions I had as well. I posted them below because I notice a lot of women on forums are asking what to ask too. So I'm sharing. Unless your interested in this sort of thing, the following may be boring. Click here for something more fun.

Questions That Will Likely Go Unanswered By My OB

What type of placenta previa do I have? Is it complete, marginal or partial?

How many CM wide is my cervix?

How many CM of placenta are overlapping my cervix?

How many CM away from the cervix must the placenta be in order to be cleared for vaginal delivery?

Is the placenta centralized over the cervix?

Is the placenta anterior or posterior? Is it leaning to one side? If so, which side?

What are the chances at present that this can resolve on its own?

Is the fetus having any growth abnormalities, deformities or anomalies?

Do I have gestational diabetes or preeclampsia? If so, how does it affect my care and are there any special precautions?

Am I at risk for blood clots or thromboembolism? If so, how is this managed?

Are there any signs of other complications such as placenta accreta, increta, percreta, vasa previa or placenta abruption?

Is the placental cord single, double or presenting any abnormalities?

Can I have a MRI to rule out additional complications?

Can I be referred to a high risk clinic or have a perinatal specialist involved in my care?

What follow-up care will I need for the rest of my pregnancy?

Can I be monitored monthly by ultrasound for placental localization changes?

What exactly are my activity restrictions?

What is the most weight I can lift?

How much housework can I do?

How much walking can I do?

What kind of exercise can I do?

What kind of travel can I do? Car? Boat? Plane?

How much weight gain should I aim for?

Do I need to modify my caloric intake due to any activity restrictions?

What do I do in the event of a yeast infection?

What do I do in the event of constipation?

What can I do to prevent constipation?

How should I respond to BH contractions?

What symptoms should I look out for? Fever? Shortness of breath?

How should I respond to pain or cramping but no blood?

How should I respond to bleeding? When should I go to the ER?

If I start to bleed heavily and am waiting for an ambulance, is there anything I can do to prevent massive blood loss or decrease bleeding?

How should I respond to mucus discharge or signs of cervical shedding?

What bed rest policies are in place? (For instance, if I bleed once will I be put on bed rest? If I bleed more than once, will I be hospitalized?)

Are there any special foods or drugs that are usually safe during pregnancy that I should avoid specifically? Could anything bring on contractions or increase likelihood or severity of bleeding?

If the placenta doesn't clear, does the hospital give steroid shots for fetal lung development? If so, at how many weeks?

If the placenta doesn't clear, will I need to take tocolytics?

If the placenta doesn't clear, does the hospital conduct amniocentesis for fetal lung monitoring? If so, at how many weeks?

If the placenta doesn't clear but there are no other complications, when will a c-section be scheduled?

Are placenta previa c-sections conducted under general or spinal anesthesia?

If placenta is anterior and a c-section is required, will the surgeon do a vertical incision or cut through the placenta?

Can I store my own blood in case of the need for a transfusion? If so, how can I arrange that?

Can I donate my afterbirth to research? If so, how can I arrange that?

What procedures and policies do I need to know about regarding a c-section?

What procedures and policies do I need to know about regarding the NICU?

What local and hospital resources do I have at my disposal?

How can I get the rest of my questions answered, if they were not answered?

That concludes my daily episode of O.C.D.

Hope For The Best, Prepare For The Worst

I like to remind myself that I'm mildly optimistic about this situation turning itself around. But I'm naturally a realist who accepts the facts. So every day I'm trying to learn a little more about the possibilities, probabilities and what to do next to improve odds in favor of my interests.

Tonight I looked into any tips on being prepared for an emergency specific to this condition. I was surprised to see so little consistent advice on the subject. I must have surfed for 45 minutes straight. A hint here and a hint there... with 1 in every 200 pregnancies having this issue, I'm baffled that there isn't more on this subject; even to offer assurance. Because every pregnancy is different, there isn't a 1 way of doing things. Meanwhile, I read stories of regrets and "only if I" type statements. Everything seems to come down to, "If you bleed, go to the hospital.

I'm gathering what happens is, nobody wants to "worry the pregnant lady" or add stress. So the general advice is to "leave it to the professionals." Simultaneously, I also read the professionals get it wrong - A LOT. What a conundrum. Few seem to think that knowledge is power. Instead the general philosophy is that ignorance is bliss, take it easy, knit some booties. Not in my case.

I wish it was this easy.

So here is my offering to the community from one paranoid mom to the next:

Bare Bones SHTF List

1. Have a telephone on you at all times. Two is even better. Make sure it's always charged and you have a backup battery and charger in your pocket book. When in the house, keep your cordless in your pocket.
2. Set your alarm clock/phone/pc to go off every hour if sleeping, especially while home alone. Wake breifly to check for spotting, roll over and go back to sleep. It will suck at first but since you'll be getting up every few hours once the baby is born, it's not a bad idea to learn to sleep lightly.
3. Stay within 30 minutes (driving, in heavy traffic) of a hospital with an ER. The closer the better if possible. If this isn't doable, ask your hospital and municipality about services and resources in your area. I read somewhere that the people at Ronald McDonald House actually have resources also.
4. Create and distribute a contingency plan with phone numbers, insurance numbers, passwords, basic information including medical information, bank access information, will, notes, instructions for child care of other kids etc. Keep a copy in your bag. Keep a copy on you. Give a copy to a few trusted emergency contacts. Just imagine being unconscious and nobody knowing your allergies or your hubby's phone number. Also include in the plan a pickup for young children. Having to collect them from SOCIAL SERVICES later should be a last resort if avoidable (but remember, you can call them too if you have absolutely NOBODY else to call.)
5. Pack the basics now and have a list of things that aren't packed but needed in case of hospitalization. The proverbial pregnancy "bug out bag" may not have your laptop, smartphone or things you use daily; but at least you'll not have to leave your bra selection to your mother. List the location of the bag in your contingency plan.
6. Practice relaxation techniques, get a therapist and try biofeedback too. Stress and panic cause bleeding to accelerate. If you start to bleed, staying extremely calm is essential to slowing blood loss.
7. Get the best care you (or your insurance) can afford. Many places will assure you that your OB is good enough. If you choose to be with them vs. a specialist because of comfort, that should be the only reason. Otherwise, seek a Perinatal specialist to be involved in your care. I hear it can make a big difference in results.
8. Don't avoid steroids, Rhogam or other prepatory treatments as advised late in pregnancy if CPP is persistent. These can be life saving. I try to stay as natural as possible within reason. But avoiding these defies reason IMO, when your actual immediate life and baby's immediate life is in the balance.
9. Listen to your body. If you feel weird, stop whatever you're doing and if possible, lay or sit down. Many accidents seems to happen when women ignore bodily warnings or act like a super-hero.
10. Be conditioned to call 911 FIRST, not your husband, doctor or anyone else, at any sign of bleeding or concerning pain. Even if you are going to have someone drive to the hospital because you'd get there faster, give the operator your route regardless of defiance. Never drive yourself, as you could pass out while driving. [Many advise women to wait for an ambulance but it's impractical when for instance, you're 5 minutes away and the ambulance takes 10-20 just to arrive; and someone can take you NOW.]

That concludes the best advice I've gathered on the subject. I hope it's enough.

Boredom Busters: Best Rest Activities

I have to admit to myself that I'm a very active person and burdened by what my body needs me to do right now. Simultaneously, I'm all about making sure things go well. I'm going to need to find things to do in my house, preferably laying or sitting down. I'm not officially on 'bed rest', only 'restricted activity.' But listening to my body lately, I need to chill the heck out more often.

This is a running list (may be edited in the future) of ideas of things to do on bed rest. Awe, running... I miss running. Anyhow, here we go:

• Get into reading a book series or author. Any suggestions?
• Learn a new language. Get tapes, books, DVD's or use online lessons.
• Take an online class or open-course.
• Write stories, poetry, keep a journal or blog.
• Kindle :)
• Best rest exercise/yoga
• Watch TV and movies, DVD's and/or subscribe to a streaming service
• Play video games, X-Box, PSP, etc.
• Make scrapbooks by hand or online using a printing service
• Christmas shop online or start birthday shopping in advance.
• Clip coupons and prepare shopping lists
• Spell check your blog... ummmmmmmmmmm lol
• Do puzzles (crosswords, sodoku, word-search)
• Play cards/solitaire (with real cards lol)
• Start beading something, jewelry, gifts or post-partum swag
• Make a quilt
• Organize the laptop files, update address book, delete spam, etc.
• Surf the internet aimlessly
• Social network (Facebook, etc.) or find lost relatives
• Play online or Facebook games
• Do online surveys for money
• Start a web based business
• Design websites
• Draw or do graphic design, sketch portraits
• Sew on a mini-machine or by hand (make mittens, booties, etc.)
• Do a variety of arts and crafts
• Knit or crochet stuff
• Make friendship bracelets
• Do some cross stitch or needlepoint
• Groom endlessly: e.g. paint and re-paint nails
• Play with make up and hairstyles
• Count blessings

Add any suggestions you have in a comment.

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